A Perspective on 360-Degree Evaluations

From the Department of Pediatrics, Boston University School of Medicine (R.G.), the Department of Pediatrics at Boston University Medical Center (B.Z.), and the A decade after the introduction of the Accreditation Council for Graduate Medical Education (ACGME) Outcomes Project, a mystique continues to surround 360-degree evaluations. The ACGME requires residency training programs to provide objective assessments of resident performance and improvement in the 6 general competencies of patient care, medical knowledge, practice-based learning and improvement, interpersonal and communication skills, professionalism, and systems-based practice. It further requires that these assessments involve the use of ‘‘multiple evaluators’’ (eg, faculty, peers, patients, self, and other professional staff), essentially mandating the use of 360-degree evaluations. In the Boston Combined Residency Program at Boston Medical Center and Children’s Hospital Boston, we have developed and completed piloting of a 360-degree evaluation for use on the general pediatrics ward at Boston Medical Center. With support from the Arthur Vining Davis Foundation to encourage caring attitudes in our trainees, we have challenged ourselves to devise a process that has evaluative and educational integrity with an obvious and meaningful impact on how our residents understand the work they do. Our 360-degree evaluation emphasizes interpersonal and communication skills, and professionalism. In various presentations, we have found that others have many of the questions we had as we began, and so we share what we have learned in the spirit of furthering the goals of the Outcomes Project. We especially want to comment on limitations to claims about the reliability and validity of evaluation tools in the context of medical training, and on the hidden opportunity to help residents develop important leadership skills.